Jacobson v. Commonwealth of Massachusetts

Jacobson v. Commonwealth of Massachusetts (1905) is a classic case dealing with the public health and welfare, as one citizen unsuccessfully protested government-required vaccinations. Jacobson stands out as one of only two Supreme Court cases (the other reached a similar result in Zucht v. King, 1922) that allowed American public school systems to require incoming students to be inoculated against specified diseases prior to starting school.

The whole point is that, should a few students suffer from one of the maladies that had spread throughout vast numbers of children and adults, then they could potentially begin another epidemic, especially if classes were intermingled with those who received vaccinations and those whose parents opted not to do so. According to the Supreme Court’s opinion in Jacobson, by insisting that all children must be vaccinated, no one is allowed a free ride at the risk of others. This entry reviews the case and its potential application to terrorism-related initiatives.

Facts of the Case

During the early years of the 20th century, Massachusetts witnessed a large increase in the number of smallpox deaths. In response, many communities there required vaccinations of their residents to try to stop the spread of the disease. In 1903, because the plaintiff, Henning Jacobson, believed that the smallpox vaccination was unsound for his health, he refused to have the vaccination that the city of Cambridge required of all of its residents. Pursuant to applicable law of the commonwealth, Jacobson was fined $5 for his refusal to be inoculated.

Jacobson then unsuccessfully filed suit, as the Supreme Judicial Court of Massachusetts found that the local statute was consistent with the commonwealth’s constitution. On further review, Jacobson argued before the U.S. Supreme Court that the law violated his Fourteenth Amendment right to liberty, because it took away his right to care for his own body in the way that he deemed best.

The Court’s Ruling

In unanimously upholding the constitutionality of the statute, the Court pointed out that part of being in a civilization meant giving up some personal freedom in exchange for belonging to that society. As such, the Court’s decision hinged on the fact that Jacobson would enjoy the fact that he would be protected from smallpox because his neighbors had been inoculated, while he would not personally have had to accept the risk that was inherent in the vaccination. The Court viewed his rejection as an attempt to get a free ride from society.

The Supreme Court next considered whether Jacobson’s right to contest the scientific basis of the vaccinations was legitimate. Although conceding that some people still doubted the efficacy of the vaccination, the Court determined that the legislature was within its prerogative in adopting one of many views based on its own study of the alternatives. The Court thus ruled that commonwealth officials engaged in a legitimate use of their police power in exercising the right to protect the public health and safety of citizens. The Court concluded that because local boards of health determined when mandatory vaccinations were necessary, such a requirement satisfied the Fourteenth Amendment, because it was neither unreasonable nor arbitrary. Vaccinations, of the kind at issue in Jacobson, are still a topic of some discussion and controversy, as occasional lawsuits still challenge the legitimacy of mandatory vaccinations and inoculations as a precondition of having children attend school.

Terrorism Application

In 2003, the Journal of the American Medical Association (2003) published an article about the use of Jacobson in an age of bioterrorism. Since the terrorist attacks in the United States in 2001, there has been a significant amount of discussion and planning for methods that could be used to inoculate most of the American population in the event of bioterrorism.

Jacobson still stands for the proposition that if it would benefit the public welfare, then the American people could be required to be inoculated, even against their will. The critics of the Model State Emergency Health Powers Act (MSEHPA) maintain that the law grants state governors a great deal of power to react in the event of medical emergencies. These critics argue that the society is not the same as the one in which Jacobson was decided, and that the MSEHPA puts too much power into the hands of the government. As with many issues, this is a controversy that will continue to linger on in schools and the wider society.

James P. Wilson

See also Vaccinations, Mandatory

Further Readings

Joseph, D. G. (2003). Uses of Jacobson v. Massachusetts in the age of bioterror. Journal of the American Medical Association, 290, 2331.